Quality of laparoscopic camera navigation in robot-assisted versus conventional laparoscopic surgery for rectal cancer: An analysis of surgical videos through a video processing computer software.

Background: To compare laparoscopic camera navigation (LCN) quality between robot-assisted laparoscopic surgery (RALS) and conventional laparoscopic surgery (CLS).

Methods: 20 recordings were selected by propensity score matching and subjected to Python® software to generate single frames at one second intervals. For each frame, the pixel where the camera should be centred, based on instrument position, current action (dissection/haemostasis/traction) in the frame, was detected. LCN quality was reviewed by two independent surgeons to evaluate erroneous LCN.

Results: RALS had higher incidence of centred views (83.1 ± 4.02% vs. 76.0 ± 2.38%, p < 0.05) and a shorter distance between actual and optimal frame centres (123.3 ± 9.8 vs. 144.8 ± 13.9, p < 0.05) compared to CLS. Erroneous camera navigations were more frequent in CLS regarding total time of horizontal alignment failure (2.1 ± 2.2 vs. 6.0 ± 5.4 min, p = 0.063) and number of excessive zoom-in visualization (0.1 ± 0.3 vs. 1.9 ± 1.4, p = 0.003).

Conclusions: RALS provided higher LCN quality than did CLS, emphasising the benefits of a surgeon-controlled view.